[Craniopharyngioma--comparison of postoperative course following tumor and palliative surgery]

The results of surgical treatment of 86 craniopharyngioma patients are followed up in the postoperative and later periods. Under the indication of progressive impairment of vision by direct pressure on optical structures the direct tumour operation was carried out in 50 cases. The postoperative lethality of 32%, the total lethality within one year of 36% and within 5 years of 44% correspond to the world level and show an increasing improvement in the last few years. The relative independency of the postoperative lethality rate of the degree of radicality speaks for a correct appraisal of the operability limit which is given by the vicinity of the diencephalic structures. With the indication of prevailing cerebral compression and the formation of hydrocephalus by a blocking of the foramen of Monro a spinal-fluid draining operation instead of a tumour operation was carried out in 33 cases. The results of bilateral Torkildsen drainage are compared with those obtained with valve draining. It appears that the bilateral placing of a Cordis-Hakim valve is the best method, especially because no functional impairment due to a possible increase in rachialbumin need be expected.